[Malignant bone tumors--is amputation still necessary today?]

Area of Science:

• Oncology
• Orthopedic Surgery
• Medical Diagnostics

Background:

• Solid primary bone tumors are rare, accounting for only 0.5% of all malignant tumors.
• Early diagnosis is critical, especially for osteosarcoma and Ewing sarcoma in adolescents, where prognosis is favorable with adequate treatment.
• Bone tumors should be suspected with unilateral extremity pain, particularly nocturnal pain, necessitating X-rays.

Purpose of the Study:

• To outline the diagnostic and treatment protocols for solid primary bone tumors.
• To emphasize the importance of early detection and multimodal treatment strategies.
• To present survival rates associated with current treatment approaches for specific bone tumor types.

Main Methods:

• Diagnosis is confirmed by biopsy.
• Treatment for osteosarcoma and Ewing sarcoma involves neoadjuvant chemotherapy followed by wide surgical resection.
• Histologic examination assesses tumor response to chemotherapy, guiding further treatment adjustments.
• Chondrosarcomas and other low-grade tumors are treated surgically.

Main Results:

• Modern treatment protocols achieve a 70% survival rate for osteosarcoma.
• Survival rates of 50% are realistic for Ewing sarcoma, despite early metastasis.
• Effective chemotherapy leads to over 90% tumor necrosis in good responders.
• Amputation is rarely required due to precise tumor extent knowledge and limb-sparing surgical techniques.

Conclusions:

• Multimodal treatment, including chemotherapy and surgery, significantly improves survival rates for malignant bone tumors like osteosarcoma and Ewing sarcoma.
• Accurate staging and response assessment are key to tailoring treatment and optimizing outcomes.
• Surgical expertise is vital for successful resection of chondrosarcomas and other less aggressive bone tumors.